It is the policy of San Juan Health to provide essential services regardless of the patient’s ability to pay. Discounts can be offered based on household size and annual income through our charity care/sliding scale program.
Please complete the linked application (blue box below) to determine if you and members of your household are eligible for a discount. Please remember to include copies of your Medicaid denial letter (go to https://medicaid.utah.gov/ to apply), insurance cards, income information, and other documentation listed below in the Documentation section of this form. Documentation must be submitted with this application before a discount can be considered for approval.
Once you have completed the form, you can send the completed application* (with accompanying documentation) via email to Heather Stocks (email@example.com) if you are comfortable with sending personal information via your email provider (if your email provider allows you to send a secure, encrypted email that is the option you should choose–San Juan Health cannot be held responsible if your email is not secure, if your information is compromised in the sending/transmission process, etc.). If you prefer to mail in the application and supporting documentation please send to:
San Juan Health Attn: Heather Stocks 380 West 100 North Monticello, UT 84535
And as always–if you live locally–you are welcome to deliver the application and supporting documentation to Heather or to someone in the billing office in the admin building.
Please understand that, if approved, the discount will only apply to applicable services received at San Juan Health and not those services or equipment that are purchased from outside the organization including reference laboratory testing, drugs, x-ray interpretation by a consulting radiologist, and other such services.
*This form must be completed each year or again if your insurance status or financial situation changes more than $250 a month.